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. 2022 May;18(5):248-291.

Single-Use Duodenoscopes for ERCP: Rationale, Feasibility, Cost, and Environmental Impact

Timothy Lee  1 , Sarah Enslin  2 , Vivek Kaul  2
Affiliations

Single-Use Duodenoscopes for ERCP: Rationale, Feasibility, Cost, and Environmental Impact

Timothy Lee et al. Gastroenterol Hepatol (N Y). 2022 May.

Abstract

Recent outbreaks of duodenoscope-associated multidrugresistant organism infections have increased awareness and concern about the pitfalls in high-level disinfection protocols and duodenoscope design. A call for innovative approaches to reduce the risk of transmission of multidrug-resistant organisms through duodenoscopes has led to the development of single-use duodenoscopes. As a new technology, questions have been raised regarding the performance, safety, cost, feasibility of implementation, and environmental impact of these novel duodenoscopes. This article discusses several of these aspects and presents a brief review of the literature.

Keywords: Duodenoscope; disposable; infections; multidrug-resistant organisms; single-use.

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Figures

Figure 1.
Figure 1.
EXALT Model D single-use duodenoscope. A: Handle of scope. B: Head of scope (dial view). C: Distal end. D: EXALT controller with EXALT Model D singleuse duodenoscope. All images provided courtesy of Boston Scientific.
Figure 2.
Figure 2.
Ambu aScope Duodeno. A: Distal tip with elevator. B: Ambu aScope Duodeno (view of entire device). C: Duodenoscope head (dial view). D: Duodenoscope head with view of accessory channel. All images provided courtesy of Ambu.
Figure 3.
Figure 3.
Typical concerns and factors impacting decision-making related to the single-use duodenoscope paradigm. CRE, carbapenem-resistant Enterobacteriaceae; MDRO, multidrug-resistant organism.
Figure 4.
Figure 4.
Areas for future research involving single-use duodenoscopes.
See this image and copyright information in PMC

References

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    1. Epstein L, Hunter JC, Arwady MA et al. New Delhi metallo-β-lactamase-producing carbapenem-resistant Escherichia coli associated with exposure to duodenoscopes. JAMA. 2014;312(14):1447–1455. - PMC - PubMed

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